Acinetobacter baumannii-associated skin and soft tissue infections: recognizing a broadening spectrum of disease

Dubert M Guerrero1, Federico Perez, Nicholas G Conger

  • 1Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, Cleveland, OH 44106, USA.

Surgical Infections
|October 1, 2009
PubMed
Abstract

Insights

Acinetobacter baumannii can cause severe necrotizing skin and soft tissue infections (SSTI), often with bacteremia. High mortality rates and drug resistance complicate treatment, requiring surgical debridement.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Acinetobacter baumannii is an emerging cause of nosocomial infections.
  • Its role in skin and soft tissue infections (SSTI) is increasingly recognized, particularly following military conflicts.
  • Reports of severe wound infections and SSTI caused by this pathogen are rising.

Observation:

  • This study details four cases of necrotizing SSTI caused by Acinetobacter baumannii, with associated bacteremia.
  • A literature review of similar cases was conducted to identify common characteristics.
  • The infections were sometimes polymicrobial, involving other pathogens alongside A. baumannii.

Findings:

  • Necrotizing SSTI associated with A. baumannii often occurs in patients with comorbidities like trauma or cirrhosis.
  • Bacteremia frequently accompanies these severe skin infections.
  • Multiple drug resistance and co-pathogens complicated treatment in 64% of cases.
  • Surgical debridement was necessary in 84% of reported and reviewed cases.
  • The mortality rate for these severe infections was approximately 30%.

Implications:

  • As Acinetobacter baumannii prevalence increases, clinicians should anticipate more severe SSTI cases.
  • Awareness of the potential for severe necrotizing SSTI caused by A. baumannii is crucial for timely diagnosis and management.
  • Vigilance for complications, including bacteremia and drug resistance, is necessary for effective patient care.

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